LRGH annex for psychiatric patients called model for other hospitals

LACONIA — At any given time, people who have been assessed as a danger to themselves or others wait in hospital emergency rooms for a slot to open at an inpatient mental health facility.

At Lakes Region General Hospital, they wait at a six-bed annex that has become a model for other hospitals, said Kevin Donovan, president and chief executive officer of LRGH.

Donovan said the hospital is surveyed every year by DNV GL Healthcare, which accredits hospitals based on standards set by the Centers for Medicaid & Medicare Services.  

“Recently we heard back from DNV who said we really were a model of success for other organizations to follow,” Donovan said. “Some of our peers in New Hampshire have come to visit us to understand what we’ve done to be a model of success so they can mirror that in their communities.”

The problem, he said in a recent interview, is “there aren’t enough inpatient mental health beds in the state of New Hampshire or the country.”

As a result, “we end up holding folks as they wait for beds,” Donovan added.

Across the state, there are usually about 50 people on the waiting list.  

“People can wait multiple days,” he said. “We want to make sure it is a safe environment for them and that they are actually getting some treatment, whereas in most emergency rooms, all you do is just wait. So we really are providing a better experience than most.”

Like other facilities for the mentally ill, the physical environment at the annex needs to be made safe, said Marge Kerns, vice president for clinical services.

“There are special beds, ceilings that are solid and can’t be pushed up, receded door hinges, receded door handles,” she said. “Every table in the common room had to be able to be bolted to the floor so somebody with a lot of strength can’t pick it up and throw it. The televisions had to be enclosed.”

The entire emergency room recently underwent a $7.2 million renovation, including about $150,000 in improvements at the annex, Donovan said.

While in the annex, patients are under the care of medical professionals. Medications can be started or adjusted.

“Studies show the earlier you can adjust medications, the quicker they are no longer at risk to harm themselves or others,” Kerns said.

Dr. Raymond Suarez, who is the chief of psychiatry at LRGH and Franklin Regional Hospital, said the hospital system is committed to providing quality psychiatric medicine.

“I’m originally from New York City, did my medical training there and worked at hospitals in New York and Connecticut,” he said. “The reason I made the big switch to come here was because of how dedicated Lakes Region was to psychiatry. For a lot of hospitals, psychiatry is an afterthought.

“Psychiatric services are not a money-maker anywhere across the country, but it’s a necessary thing and the need is growing and growing and growing.

“Lakes (Region Health Care) has put a lot of money and effort into the care of the patients. Patients have always been the No. 1 priority.”

Suarez said people come in with a wide range of psychiatric conditions.

“The biggest ones are depression and suicidality, psychosis with agitation or suicidality, bipolar disorder with mood lability causing issues in their own life,” Suarez said.

Sometimes, treatment at the annex can be effective quite quickly.

“Somebody who stopped taking medication, couldn’t get to a provider, comes in psychotic, agitated,” he said. “We restart medications. Anti-psychotics work very quickly and within a day or two they may be completely clear and back to their baseline.

“We contact the outpatient providers. We make their appointments and then we can discharge them back to the community.”

Those needing inpatient treatment are placed at New Hampshire Hospital, Cypress Center, Portsmouth Regional Hospital, Franklin Regional Hospital or Elliot Hospital.

This can be a bad time of year for those suffering from mental health issues.

“There is less light outside and that causes seasonal depression,” Suarez said. “Also holidays are a rough time for people. Holidays are stressful.”

Also, families get together and that can lead to problems as well.

“These are difficult times for people,” he said. “They may need just a little bit of a boost.”

To contact Rick Green, send him an email at

rick@laconiadailysun.com.